News & Analysis as of

Denial of Insurance Coverage Policy Exclusions

Marshall Dennehey

Court Denies UIM Coverage to Woman, Claiming ‘Family Member’ Status Through Daughter

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Miller v. USAA General Indemnity Company, No. 23-1934 (3d Cir. Jan. 7, 2025) - The plaintiff, who resided with her daughter in the home of her daughter’s paternal grandmother, sought UIM benefits under an auto insurance...more

Rivkin Radler LLP

April 2025 New York Insurance Coverage Law Update

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John H. Fisher and his P.C. represented a client in a medical malpractice action filed on February 15, 2019, alleging that the defendant medical providers failed to provide proper prenatal care to the client, causing the...more

Carlton Fields

Eighth Circuit Finds No Coverage Under “Ensuing Loss” Provision Under Arkansas Law

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“Ensuing loss” provisions have long been the subject of nuanced arguments in insurance litigation. The provisions, which sometimes afford coverage for a “covered loss” stemming from an expressly excluded peril, serve as...more

Carlton Fields

Texas Appeals Court Finds Project Owner Excluded From Coverage as Claimants’ Statutory Employer

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On April 3, 2025, a Texas state appeals court reversed a trial court order awarding Exxon Mobil $25 million under an umbrella insurance policy issued by Lexington Insurance Co. to Brock Services Ltd. The appeals court found...more

Wiley Rein LLP

No Coverage for Lawsuit Where “Claim” First Made at Time of Pre-Inception Tolling Agreement

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In a win for Wiley’s client, a New York intermediate appellate court, applying New York law, has affirmed that no coverage is available for a legal malpractice lawsuit because the “claim” was first made before the policy’s...more

Morris, Manning & Martin, LLP

Policyholder Concerns after Georgia Federal Court Takes Broad Reading of Pollution Exclusion

In Citizens Ins. Co. of Am., et al. v. Augusta Chiller Service, Inc., et al., the Southern District of Georgia granted insurers' motions for summary judgment in part on their duty to defend under a primary and excess policy...more

Carlton Fields

Eleventh Circuit Holds Course of Construction Exclusion Applies to Water Damage as Project Was Not Fully Complete

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In Liberty Surplus Insurance Corp. v. Kaufman Lynn Construction Inc., the Eleventh Circuit Court of Appeals held that a “course of construction exclusion” in a commercial general liability precluded coverage for water damage...more

Lathrop GPM

California Courts Continue to Grapple with What Constitutes Wildfire “Direct Physical Loss or Damage”

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In Gharibian et al., v. Wawanesa General Insurance Company, the California Second District Court of Appeal found that, under California law, the insureds failed to prove smoke, soot, ash and fire debris on covered property...more

Carlton Fields

Recent Denial of Business Interruption Coverage to Cannabis Manufacturer Highlights Importance of Diving Into the Weeds of...

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In Theraplant LLC v. National Fire & Marine Insurance Co., the U.S. District Court for the District of Connecticut denied the insured cannabis cultivator’s claim for business interruption coverage because the insured failed...more

Carlton Fields

A Bridge Too Far: Pennsylvania Federal Court Declines to Extend Coverage Beyond Policy’s Plain and Unambiguous Terms

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It’s apt to name a blog post after one of history’s great action movies when the case involves a “conceptual artillery duel” that “ends in a draw,” and that is exactly how U.S. District Judge Gerald Austin McHugh Jr. of the...more

Marshall Dennehey

Statute of Limitations Stands: Pennsylvania Superior Court Affirms Dismissal of Breach of Contract Claim Against Insurance Broker

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The Pennsylvania Superior Court recently affirmed the Philadelphia County Court of Common Pleas’ dismissal of breach of contract claims asserted against an insurance broker in Thuong Erin Wasielewski, Individually and as...more

Marshall Dennehey

Adequate Notice Requires More Than Delivery of a Policy

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A December 31, 2024, decision from the Supreme Court of Idaho found that adequate notice to an insured required more than the delivery of a policy and, due to the insurer’s failure to do so, coverage under a pre-existing...more

Rivkin Radler LLP

February 2025 Insurance Update

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The 2014 Home Depot data breach was one of the more notorious cyberattacks. A decade later, litigation over that incident continues. The Sixth Circuit recently decided whether an electronic data exclusion cleared insurers...more

Segal McCambridge

New York Appellate Court Clarifies Insurer Obligations Under the Child Victims Act

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The New York Appellate Division Fourth Department recently issued a decision affirming in part and reversing in part summary judgment motions against GuideOne Mutual Insurance Company (“GuideOne”) in a case brought by The...more

Wiley Rein LLP

Electronic Data Exclusion Precludes Coverage for Payment Card Data Breach

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The United States Court of Appeals for the Sixth Circuit, applying Georgia law, has held that the electronic data exclusion in commercial general liability (CGL) policies issued to a retail store company precluded coverage...more

Bradley Arant Boult Cummings LLP

North Carolina Supreme Court: Government-ordered business closures during COVID-19 lockdowns constitute 'direct physical loss'...

Steven Hix and G. Benjamin Milam of Bradley discuss a pair of recent North Carolina Supreme Court rulings on coverage for pandemic-related losses, one of which gave policyholders a rare win. On December 13, the North...more

Rivkin Radler LLP

January 2025 New York Insurance Coverage Law Update

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The insured owned premises located in Huntington Station, NY. The Claimant was allegedly injured when she slipped and fell at the premises. The Claimant sued the insured and the insured sought coverage under her homeowners...more

Rivkin Radler LLP

New York Insurance Coverage Law Update — Compilation 2024

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An owner, general contractor (GC) and subcontractor (Sub) were sued by injured workers at a construction site, and they were defended by the Sub’s insurer, U.S. Specialty Insurance Company. U.S. Specialty tendered their...more

Kilpatrick

COVID All-Risk Policies

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In a ruling that bucked the national trend, the North Carolina Supreme Court recently held that restaurants’ business interruption losses caused by the COVID shutdown were covered under an all-risk property policy. North...more

Houston Harbaugh, P.C.

Supreme Court Of North Carolina Holds That Losses Caused By The COVID-19 Shutdown Orders Are Direct Physical Loss Covered By...

On December 13, 2024, the Supreme Court of North Carolina broke with the nationwide trend, holding that, absent a virus exclusion, commercial property insurance policies cover losses covered by the shutdown orders issued in...more

Lowenstein Sandler LLP

Taking the Right Steps To Navigate the Consent To Settle Provision in an Insurance Policy and Maintaining the Right to Coverage...

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Insurers often try to withhold, or at least minimize, coverage by taking the position that a policyholder has failed to keep the insurer sufficiently informed throughout the defense of an underlying matter or has failed to...more

Zelle  LLP

Is Your War Exclusion Fit for Purpose?

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As global threats evolve, so does the question of what constitutes a ‘war’ risk under a standard property insurance policy, and how this might impact coverage. Historically, a war was a physical conflict between two or...more

Zelle  LLP

The Zelle Lonestar Lowdown Issue 20 - December 2024

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Welcome to The Zelle Lonestar Lowdown, our monthly newsletter bringing you relevant and up-to-date news concerning Texas first-party property insurance law. Inside this Issue: - Todd Tippett’s Top Ten Consultants an...more

Sheppard Mullin Richter & Hampton LLP

An Insurer is not Vicariously Liable for Actions by an Agent That Are Outside the Scope of the Agency Relationship and Were...

In December 2020, Plaintiff Erin Hughes applied for homeowners coverage for her Malibu home with her Farmers’ insurance agent. Hughes obtained a fire policy through the California FAIR Plan and a homeowners policy through...more

Wiley Rein LLP

Tenth Circuit Deems D&O Policy Ambiguous Based on Interplay of Coverage Grant with Managed Care Exclusion

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The United States Court of Appeals for the Tenth Circuit, applying Kansas law, has held that a D&O insurer was obligated to reimburse defense costs where a policy expressly covered antitrust claims but excluded coverage for...more

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